Provider Demographics
NPI:1144701582
Name:MADSEN INC
Entity type:Organization
Organization Name:MADSEN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:641-484-6198
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:GLADBROOK
Mailing Address - State:IA
Mailing Address - Zip Code:50635-0370
Mailing Address - Country:US
Mailing Address - Phone:641-473-0066
Mailing Address - Fax:641-473-0069
Practice Address - Street 1:307 2ND. ST.
Practice Address - Street 2:
Practice Address - City:GLADBROOK
Practice Address - State:IA
Practice Address - Zip Code:50635-5063
Practice Address - Country:US
Practice Address - Phone:641-473-0066
Practice Address - Fax:641-473-0069
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MADSEN, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-23
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy